Brainspotting

Development from EMDR and body-oriented work

Accounts of the method's origin come from its developer and from authors who train in it. A 2024 study by trainer-affiliated authors states that David Grand developed Brainspotting in 2003, while working as a trainer in Eye Movement Desensitization and Reprocessing (EMDR). In that account he noticed that some clients became overactivated by rapid eye movements, moved to slower eye movements he called Natural Flow, and later to a single fixed gaze position.

A 2022 comparative study similarly describes the approach as growing out of Grand's EMDR work and his training in Somatic Experiencing, with the premise that where a person looks affects how the person feels. No independent historical scholarship on the method was found, so these origin accounts should be read as developer-aligned.

First publications and spread

Two papers in the journal Medical Hypotheses, in 2013 and 2015, set out proposed neurological explanations written with Grand as co-author. The 2013 paper presents testable hypotheses about the retinocollicular pathway and midbrain, not tested findings. The first outcome data cited here were collected from 2009 to 2012 by seven therapists in the United States and Germany and reported in a preliminary study accepted in 2014.

The authors of that preliminary study, one of whom was the developer, noted that use of the method was increasing in South America and Spain, and they translated their questionnaires into Spanish for later work. Published research since then remains sparse, as described in the evidence section.

Brainspot and related terms

In the literature, a brainspot is the eye position that practitioners associate with a client's body activation while the client attends to a distressing issue. The preliminary study explains the word as brain plus spot, and describes the assumption that such positions resonate with implicit memory content. This is a practitioner concept, and the sources reviewed do not show that a specific eye position corresponds to a measurable neurological source.

Different methods of finding a position carry separate names. Inside Window relies on the client's felt sense of activation. Outside Window relies on reflexive responses the therapist observes, such as blinking or sudden breathing changes. Gazespotting uses the place the client's eyes settle spontaneously while talking. The terms focused mindfulness and dual attunement describe, respectively, the client's open observation of internal experience and the therapist's simultaneous attention to the client's physiology and the relationship.

Distinction from EMDR

Brainspotting is a separate named method, not a variant label for EMDR. Authors describing both note that EMDR uses rapid bilateral eye movements, whereas Brainspotting holds the eyes on one position. Research on EMDR, including the question of whether eye movements add to its effect, concerns a different procedure and should not be read as research on Brainspotting.

Finding a gaze position

Published descriptions begin with the client naming an issue and rating the level of distress or body activation, often on a Subjective Units of Distress scale. In the Inside Window procedure used in one study, the therapist moved a pointer of about 80 centimeters slowly across the client's visual field while the client monitored body activation, and the position with the strongest activation was chosen as the brainspot.

Processing phase

Once a position is chosen, the client keeps the gaze there and reports internal sensations, emotions or memories at intervals while the therapist stays mostly silent. Two studies describe slow bilateral sound played through headphones, ocean waves in one and soft music in the other. In the preliminary study the protocol also included a step in which the client deliberately raised the distress level again before a final check of the original issue.

These details come from study protocols, which fix the format for research purposes. A single study session lasted about 40 minutes in one trial and the preliminary study used three sessions. The sources do not establish how typical practice varies, so they should not be read as a standard session length or number of sessions.

Training and certification

The organization that trains in the method lists Phase 1 and Phase 2 courses, with advanced courses in Phases 3 to 5 and a Master Class. Its initial certification requires one advanced course, 50 documented sessions, six hours of consultation with an approved consultant, proof of liability insurance or a waiver request, and agreement to a code of ethics. Its page says the standards take effect on November 1, 2025.

The certification page reviewed does not state that a licensed professional qualification is required to take the courses, and it does not define how trainers and consultants are approved. This is a private training body, not a statutory regime, and a certificate does not by itself show a clinical license in any jurisdiction.

Uses described by developers and trainers

Authors affiliated with the method present it mainly as a treatment for the effects of trauma, including posttraumatic stress disorder (PTSD), and also for emotional dysregulation, anxiety and depression. The preliminary study states a goal of reducing symptoms within one to three sessions and describes the method as integrative, meaning it can be combined with other clinical approaches. These are statements of intent by people involved with the method, not independent findings.

Proposed explanations

The 2013 and 2015 papers propose that holding attention on a brainspot engages midbrain structures such as the superior colliculi, along with thalamic and cortical pathways, so that a memory can be reprocessed without distress. The authors of the 2013 paper present these as hypotheses to be tested. The abstracts reviewed do not report brain-imaging or physiological tests of them, and a proposed mechanism should not be read as evidence of clinical benefit.

Uncontrolled preliminary study

The preliminary study followed 22 adults treated by seven experienced therapists with three sessions. PTSD symptom scores, anxiety and depression scores fell between the first and last measurement, and therapists rated over 90 percent of clients as moderately or significantly improved. The authors listed limits: no comparison group, so comparison with other treatments and natural improvement could not be assessed, a small sample, only short-term follow-up, and possible enthusiasm bias. The developer was a co-author.

Randomized comparison with usual treatment

A 2024 trial in the International Body Psychotherapy Journal randomized 63 adults presenting for PTSD treatment at one clinic to five weeks of Brainspotting or treatment as usual, such as cognitive-behavioral or person-centered therapy. Only 27 completed treatment and follow-up assessments. Both groups improved. The authors report that treatment as usual did better right after treatment while Brainspotting showed more benefit at a four-week follow-up. Findings rest on small numbers after high attrition, and several authors are linked to Brainspotting training institutes.

Single-session experiment in a non-clinical sample

A 2022 within-subject study had 40 psychotherapy trainees apply four conditions to four distressing memories: EMDR, Brainspotting, body scan meditation and book reading. Distress ratings fell more after EMDR and Brainspotting than after the other two, with no clear difference between those two, at follow-up about two months later. The authors note that the sample was non-clinical, each condition was a single session, and one therapist delivered all conditions. The study does not address PTSD treatment.

Guidelines, related evidence and gaps

The 2023 VA/DoD guideline recommends cognitive processing therapy, EMDR or prolonged exposure for PTSD, and lists more than twenty named psychotherapies for which evidence was insufficient to recommend for or against. The synopsis reviewed does not name Brainspotting, so its absence is not a judgment on the method. A 2025 meta-analysis of 16 EMDR trials found small, mostly open-label studies with moderate or high risk of bias.

Whether eye movements matter in EMDR is itself debated. A 2013 meta-analysis reported an additive effect of eye movements, while a Veterans Affairs summary notes controversy about the mechanism. Such findings concern EMDR and should not be transferred to Brainspotting. Searches for this page, in PubMed and on the web, found no systematic review of Brainspotting.

Harms reported in the studies

None of the Brainspotting studies reviewed systematically reported adverse events. The preliminary study noted one client with a minimal worsening of symptoms by therapist rating. In the 2022 experiment, the one reported side effect, fear of losing control, occurred in the EMDR condition and resolved after a session with a referral therapist. Absence of reports in small studies does not show that harms are absent.

A protocol for a systematic review of psychotherapy trials states that much less is known about the adverse effects of psychotherapy than about its benefits, and sets out to examine how often and how severe they are. The protocol is not itself a finding about Brainspotting.

Suitability and care boundaries

The method involves attending to distressing material and body sensations, and clinical samples in the studies reviewed were adults with trauma exposure treated by trained therapists. The 2022 experiment excluded people with severe clinical syndromes or personality disorders, so its results do not apply to them. The sources do not provide contraindications specific to the method.

For PTSD, guidelines recommend specific, extensively tested psychotherapies, and this page is educational and not individual advice. Brainspotting should not delay or replace assessment or necessary care, and anyone in crisis should contact emergency or crisis services. Training status does not establish clinical qualifications, so a reader can ask a practitioner about their professional license, supervision and the format of sessions.